A new review published in the European Heart Journal finds that nicotine, regardless of how it is consumed, raises blood pressure, harms blood vessels, and increases the risk of heart disease, challenging perceptions that vaping or other alternatives are safer for cardiovascular health. The researchers said all nicotine products—including vapes, nicotine pouches, heated tobacco, shisha, and cigarettes—can damage the heart and blood vessels, with risks extending to both users and people exposed to secondhand smoke or vapor.
After analyzing decades of research, the authors warn that the rapid growth of vaping, heated tobacco, and nicotine pouch use—especially among teens and young adults driven by flavors and social media marketing—could worsen public health outcomes. Researchers found that secondhand exposure to smoke and vapor can impair vascular function in non-users, prompting calls for stricter regulation.